Healthcare Provider Details

I. General information

NPI: 1639009319
Provider Name (Legal Business Name): CORA'S COTTAGE 1 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5820 HOLLAND ST
MORGANTON NC
28655-7931
US

IV. Provider business mailing address

2015 SUNNYSIDE DR
MORGANTON NC
28655-7420
US

V. Phone/Fax

Practice location:
  • Phone: 828-391-1929
  • Fax: 828-334-3278
Mailing address:
  • Phone: 828-443-7792
  • Fax: 828-764-4866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: DONNIE PUETT
Title or Position: ADMINISTRATOR/ OWNER
Credential:
Phone: 828-443-7792